An economic analysis Of retail pharmaceutical market In Nigeria: towards access expansion and policy

Abstract

Rural areas in much of sub-Saharan Africa access needed health care from untrained and often poorly regulated drug vendor shops with concerns over the quality of products and services provided and their public health implications. The thesis undertook to understand market relationships in a rural retail drug market in the light of the structure-conduct-performance paradigm and isolate opportunities for potential policy interventions for improved access to quality and safer medicines. Data was collected from a sample of patent medicine vendors and drug purchasers in Katsina-Ala Local Government Area of Benue State, north central Nigeria, over 9 months in 2012. Information from drug vendors and drug consumers was generated through semi-structured questionnaires, in-depth interviews and systematic business transaction observations. Key state and national drug regulatory officials were also interviewed in-depth and related documentary data collected and evaluated. Data analysis focussed mainly on the relationships between market structure, provider conduct, consumer behaviour and the nature of regulation, with the aim of understanding market performance in relation to access to medicines and their rational use. The study established that patent medicine vendors were an important source of medicines for inhabitants of the local government for ambulatory primary health care. Drug retailers were said to be a reliable source of a wide range of drugs provided at relatively more affordable prices and in a convenient way that satisfied consumer expectations. However, a number of market failures existed: low quality of treatment due to poor provider knowledge of diseases and drugs and therefore inappropriate prescription and dispensing practices. Ineffective regulation was also demonstrated by way of inappropriate and inadequate regulatory regime, occasioned by wide spread regulatory infractions. To attain the desirable public health objective of sustained improvement in the quality of products and services obtainable at patent medicine vendor outlets, regulatory strategies must be contextually relevant, providers must be trained and offered financial and business incentives and consumers must be empowered by accessible and timely health information for informed choices against the backdrop of strengthened and better incentivized inspectorate unit in a systematically intertwined approach.